A Review of Interventions for Drowning Prevention Among Adults

Abstract

Adult drowning is a complex and multifactorial public health challenge requiring community, national and global efforts to mitigate impacts. This study updates the evidence base for public health interventions that address adult fatal and non-fatal drowning. A systematic review was undertaken of the peer-reviewed literature for English-language primary studies published between 2011 and 2021describing a drowning intervention with adults. Twenty-two studies were included. Most studies (n = 16) were conducted in high-income countries. Yearly trends in drowning prevention intervention publications were analysed with 2015 (n = 6) the peak publishing year. Over half of the study designs were pre-post (n = 15). Intervention duration ranged from 4 hours to 11 years. Ten studies described either behaviour change theory or formative evaluation to inform design. Thirteen studies targeted interventions at a population level, seven at a group level and two at individual level. Studies identified a range of prevention strategies, categorised as behavioural (n = 9) (e.g., swimming lessons), socio-ecological (n = 8) (e.g., mandatory personal flotation devices) and mixed (n = 5) (e.g., awareness campaign and barriers to prevent access to water). A range of outcomes were described including changes in awareness, water safety knowledge, attitudes, water safety behaviours and skills, environmental, policy and regulation changes and drowning rates. Findings indicate a small but important increase in the evaluation and publication of effective interventions to prevent adult drowning. The complexity of the issues surrounding drowning requires multi-strategy and context -specific adult focused prevention interventions. Contemporary evidence that identifies effective interventions that contribute to prevention efforts is an essential first step in addressing the challenge.

Young people's alcohol use in and around water: A scoping review of the literature

“…All included studies were appraised for study quality by one author (RNC) using a checklist created using the MetaQAT framework [27]. This checklist has been used in other reviews (e.g., [28]). The MetaQAT was designed specifically to assess public health studies across various study designs.…”

“…While the original MetaQAT does not use a numerical scoring system, instead using an overall judgement for each criterion and domain, we used a three‐point scale for scoring each criterion ranging from 0 to 2, whereby 0 = criteria not met, 1 = unclear and 2 = criteria met, for a maximum score of 18. Studies scoring ≤9 were categorised as low quality, 10–14 medium quality and scores ≥15 high quality [28]. These scores and the appraisal process provide evidence for the applicability of included studies for public health policy and practice.…”

Fatal drowning in Indonesia: understanding knowledge gaps through a scoping review

“…The prevention of drowning encompasses a wide range of measures, ranging from individual-focused approaches, such as swimming training programmes, to community-based actions, such as community participation in controlling access to open water bodies, policy development on water safety regulations and providing equitable access to safe drinking water ( Crawford et al , 2014 ; Leavy et al , 2015 , 2016 , 2023 ). This emphasizes the urgent need for cohesive approaches across the spectrum of upstream, midstream, and downstream drowning prevention ( Linnan et al , 2012 , 2013 ; World Health Organization, 2014 ; Guevarra et al , 2015 ; Leavy et al , 2023 ).…”

“…Drowning prevention is closely linked to health and safety promotion ( Plitponkarnpim and Chinapa, 2014 ). By connecting drowning prevention and health promotion, a broader understanding of drowning prevention can be achieved, which includes the process of empowering individuals and communities in taking control over their own health-related behaviours and practices ( Leavy et al , 2016 , 2023 ; Giles et al , 2017 ; World Health Organization Regional Office for the Eastern Meditteranean, 2017 ). Talbot and Verrinder (2017) illustrated the concepts of health promotion in the Health Promotion Framework, which comprises of (i) medical approaches, focusing on individual risk assessment and health information; (ii) behavioural approaches, focusing on health education, skills development and social marketing; and (iii) socio-environmental approaches, focusing on increasing cross-sector partnerships and community capacity, including community action, community participation, structural change, policy development and review and economic and regulatory activities.…”